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Peritonitis

  • Chapter
Pediatric Dialysis

Abstract

Peritonitis is the major complication of dialysis in pediatric patients receiving either continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD)1,2. The infection can have a significant impact on the long-term outcome of effective dialysis in children who may be dependent upon a functional peritoneum for a prolonged period of time3. In addition, data from the United States Renal Data System (USRDS) has documented that infection, primarily peritonitis, is the most frequent cause for the initial hospitalization of children on PD, while the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) registry has revealed that peritonitis is the primary reason for modality change in the PD population4,5.

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References

  1. Warady BA, Sullivan EK, Alexander SR. Lessons from the peritoneal dialysis patient database: a report of the North American Pediatric Renal Transplant Cooperative Study. Kidney Int. 1996;49:S68–71.

    Google Scholar 

  2. Tranaeus A. Peritonitis in paediatric continuous peritoneal dialysis. In: Fine RN, Alexander S, Warady BA, editors. CAPD/CCPD in Children. Norwell: Kluwer Academic Publishers, 1998: pp. 301–47.

    Chapter  Google Scholar 

  3. Ledermann SE, Scanes ME, Fernando ON, Duffy PG, Madden SJ, Trompeter RS. Long-term outcome of peritoneal dilaysis in infants [comment]. J Pediatr. 2000;136:24–9.

    Article  PubMed  CAS  Google Scholar 

  4. United States Renal Data System’s 2002 Annual Data Report: Atlas of End-Stage Renal Diseas in the United States. Am J Kidney Dis. 2003;41:S121–34.

    Article  Google Scholar 

  5. Neu AM, Ho PL, McDonald RA, Warady BA. Chronic dialysis in children and adolescents. The 2001 NAPRTCS annual report. Pediatr Nephrol. 2002;17:656–63.

    Article  PubMed  Google Scholar 

  6. Warady BA, Schaefer F, Alexander S, Piraino B, Tranaeus A, Honda M, Holloway M, Kandert M, Salusky IB, Divino J, Mujais S, Verrina E. Consensus guidelines for the treatment of peritonitis in pediatric patients receiving peritoneal dialysis. Perit Dial Int. 2000;20:610–24.

    PubMed  CAS  Google Scholar 

  7. Burkart J, Hylander B, Durnell-Figel T et al. Comparison of peritonitis rates during long-term use of standard spike versus Ultraset in continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int. 1990;10:41–3.

    PubMed  CAS  Google Scholar 

  8. Burkart J, Jordan JR, Durnell TA et al. Comparison of exit-site infections in disconnect versus nondisconnect systems for peritoneal dialysis. Perit Dial Int. 1992;12:317–20.

    PubMed  CAS  Google Scholar 

  9. Valeri A, Radhakrishnan J, Vernocci L et al. The epidemiology of peritonitis in acute peritoneal dialysis: A comparison between open-and closed-drainage systems. Am J Kidney Dis. 1993;21:300–9.

    PubMed  CAS  Google Scholar 

  10. Monteon F, Correa-Rotter R, Paniagua R et al. Prevention of peritonitis with disconnect systems in CAPD: A randomized controlled trial. Kidney Int. 1998;54:2123–8.

    Article  PubMed  CAS  Google Scholar 

  11. North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) 2003 Annual Report. Rockville: EMMES Corporation, 2003.

    Google Scholar 

  12. Benfield MR, McDonald R, Sullivan EK, Stablein DM, Tejani A. The 1997 annual renal transplantation in chilren: Report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Pediatr Transplant. 1999;2:152–67.

    Article  Google Scholar 

  13. Schaefer F, Klaus G, Muller-Wiefel DE et al. Current practice of peritoneal dialysis in children: Results of a longitudinal survey. Perit Dial Int. 1999;(Suppl 2):S445–9.

    Google Scholar 

  14. Verrina E, Bassi S, Perfumo F et al. Analysis of complications in a chronic peritoneal dialysis pediatric patient population. The Italian Registry of Pediatric Patient Population. Perit Dial Int. 1993;13:S257–9.

    PubMed  Google Scholar 

  15. Honda M, Iitaka K, Kawaguchi H et al. The Japanese national registry data on pediatric CAPD patients: a ten-year experience. A report of the study group of pediatric PD conference. Perit Dial Int. 1996;16:269–75.

    PubMed  CAS  Google Scholar 

  16. Schaefer F, Kandert M, Feneberg R. Methodological issues in assessing peritonitis incidence in children. Perit Dial Int. 2002;22:234–8.

    PubMed  Google Scholar 

  17. Vas S, Oreopoulos DG. Infections in patients undergoing peritoneal dialysis. Infec Dis Clin N Am. 2001;15:743–74.

    Article  CAS  Google Scholar 

  18. Warady BA, Hebert D, Sullivan EK et al. Renal transplantation, chronic dialysis, and chronic renal insufficiency in children and adolescents. The 1995 annual report of the North American pediatric renal transplant cooperative study. Pediatr Nephrol. 1997;11:49–64.

    Article  PubMed  CAS  Google Scholar 

  19. Lerner GR, Warady BA, Sullivan EK, Alexander SR. Chronic dialysis in children and adolescents. The 1996 annual report of the North American pediatric renal transplant cooperative study. Pediatr Nephrol. 1999;13:404–17.

    Article  PubMed  CAS  Google Scholar 

  20. Schaefer F, Klaus G, Muller-Wiefel DE et al. Intermittent versus continuous intraperitoneal gly-copeptide/ceftazidime treatment in children with peritoneal dialysis-associated peritonitis. J Am Soc Nephrol. 1999;10:136–45.

    PubMed  CAS  Google Scholar 

  21. Boer WH, Vos PF, Fieren MW. Culture-negative peritonitis associated with the use of icodextrin-containing dialysate in twelve patients treated with peritoneal dialysis. Perit Dial Int. 2003;23:33–8.

    PubMed  Google Scholar 

  22. MacGinley R, Cooney K, Alexander G, Cohen S, Goldsmith JA. Relapsing culture-negative peritonitis in peritoneal dialysis patients exposed to icodextrin solution. Am J Kidney Dis. 2002;40:1030–5.

    Article  PubMed  CAS  Google Scholar 

  23. Piraino B. Peritoneal infections. Adv Ren Replace Ther. 2000;7:280–8.

    Article  PubMed  CAS  Google Scholar 

  24. Zelenitsky S, Barns L, Findlay I et al. Analysis of microbiological trends in peritoneal dialysis-related peritonitis from 1991 to 1998. Am J Kidney Dis. 2000;36:1009–13.

    Article  PubMed  CAS  Google Scholar 

  25. Verrina E, Honda M, Warady BA, Piraino B. Prevention of peritonitis in children on peritoneal dialysis. Perit Dial Int. 2000;20:625–30.

    PubMed  CAS  Google Scholar 

  26. Warady BA, Ellis EN, Fivush BA, Lum GM, Alexander SR, Brewer ED, Ogrinc F, Watkins S. Rush before fill in children receiving automated peritoneal dialysis. Perit Dial Int. 2003;23:493–8.

    PubMed  Google Scholar 

  27. Schaefer F. Management of peritonitis in children receiving chronic peritoneal dialysis. Paediatr Drugs. 2003;5:315–25.

    PubMed  Google Scholar 

  28. Von Baum H, Schehl J, Geiss HK et al. Prevalence of Vancomycin-resistant enterococci among children with end-stage renal failure. Clin Infec Dis. 1999;29:912–6.

    Article  Google Scholar 

  29. Troidle L, Kliger AS, Gorban-Brennan N et al. Nine episodes of CPD-associated peritonitis with vancomycin-resistant enterococci. Kidney Int. 1996;50:1368–72.

    Article  PubMed  CAS  Google Scholar 

  30. Warady BA, Fivush BA, Andreoli SP et al. Longitudinal evaluation of transport kinetics in children receiving peritoneal dialysis. Pediatr Nephrol. 1999;13:571–6.

    Article  PubMed  CAS  Google Scholar 

  31. Holtta TM, Ronnholm KA, Holmberg C. Influence of age, time, and peritonitis on peritoneal transport kinetics in children. Perit Dial Int. 1998;18:590–7.

    PubMed  CAS  Google Scholar 

  32. Andreoli SP, Leiser J, Warady BA et al. Adverse effect of peritionitis on peritoneal membrane function in children on dialysis. Pediatr Nephrol. 1999;13:1–6.

    Article  PubMed  CAS  Google Scholar 

  33. Fried L, Piraino B. Peritonitis. In: Gokal R, Khanna R, Krediet R, Nolph K, editors. Textbook of Peritoneal Dialysis. Norwell: Kluwer Academic Publishers, 2000: pp. 545–64.

    Google Scholar 

  34. Aflaiw A, Vas S, Oreopoulos DG. Peritonitis in patients on automated peritoneal dialysis. Contrib Nephrol. 1999;129:213–28.

    Article  Google Scholar 

  35. Goldie SJ, Kiernan-Troidle L, Torres C, Gorban-Brennan N, Dunne D, Kliger AS, Finkelstein FO. Fungal peritonitis in a large chronic peritoneal dialysis population: A report of 55 episodes. Am J Kidney Dis. 1996;28:86–91.

    Article  PubMed  CAS  Google Scholar 

  36. Wang AYM, Yu AWY, Li PKT, Lam PKW, Leung CB, Lai KN, Lui SF. Factors predicting outcome of fungal peritonitis in peritoneal dialysis: Analysis of a 9-year experience of fungal peritonitis in a single center. Am J Kidney Dis. 2000;36:1183–92.

    Article  PubMed  CAS  Google Scholar 

  37. Warady BA, Bashir M, Donaldson LA. Fungal peritonitis in children receiving peritoneal dialysis: A report of the NAPRTCS. Kidney Int. 2000;58:384–9.

    Article  PubMed  CAS  Google Scholar 

  38. Lui SL, Lo CY, Choy BY et al. Optimal treatment and long-term outcome of tuberculous peritonitis complicating continuous ambulatory peritoneal dialysis. Am J Kidney Dis. 1996;28:747–51.

    Article  PubMed  CAS  Google Scholar 

  39. Gadallah MF, Ramdeen G, Mignone J, Patel D, Mitchell L, Tatro S. Role of preoperative antibiotic prophylaxis in preventing postoperative peritonitis in newly placed peritoneal dialysis catheters. Am J Kidney Dis. 2000;36:1014–19.

    Article  PubMed  CAS  Google Scholar 

  40. Sardegna K, Beck AM, Strife CF. Evaluation of perioperative antibiotics at the time of dialysis catheter placement. Pediatr Nephrol. 1998;12:149–52.

    Article  PubMed  CAS  Google Scholar 

  41. Katyal A, Mahale A, Khanna R. Antibiotic prophylaxis before peritoneal dialysis catheter insertion. Adv Perit Dial. 2002;18:112–15.

    PubMed  CAS  Google Scholar 

  42. Warchol S, Roszkowska-Blaim M, Sieniawska M. Swan neck presternal peritoneal dialysis catheter: Five-year experience in children. Perit Dial Int. 1998;18:183–7.

    PubMed  CAS  Google Scholar 

  43. Chadha V, Jones LL, Ramirez ZD, Warady BA. Chest wall peritoneal dialysis catheter placement in infants with a colostomy. Adv Perit Dial. 2000;16:318–20.

    PubMed  CAS  Google Scholar 

  44. Schroder CH, Bakkeren JA, Weemaes CM et al. IgG2 deficiency in young children treated with continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int. 1989;9:261–5.

    PubMed  CAS  Google Scholar 

  45. Neu AM, Furth SL, Lederman H, Warady BA, Fivush BA. Hypogammaglobulinemia in infants on peritoneal dialysis. Perit Dial Int. 1998;18:440–3.

    PubMed  CAS  Google Scholar 

  46. Bouts AH, Davin JC, Krediet R, van der Weel MB, Schroder CH, Monnens LAH et al. Immunoglobulins in chronic renal failure of childhood: Effects of dialysis modalities. Kidney Int. 2000;58:629–37.

    Article  PubMed  CAS  Google Scholar 

  47. Cameron JS. Host defences in continuous ambulatory peritoneal dialysis and the genesis of peritonitis. Pediatr Nephrol. 1995;9:647–62.

    Article  PubMed  CAS  Google Scholar 

  48. Furth SL, Donaldson LA, Sullivan EK et al. Peritoneal dialysis catheter infections and peritonitis in children: A report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Nephrol. 2000;15:179–82.

    Article  PubMed  CAS  Google Scholar 

  49. Piraino B. Peritonitis as a complicaton of peritoneal dialysis. J Am Soc Nephrol. 1998;9:1956–64.

    PubMed  CAS  Google Scholar 

  50. Piraino B. Management of catheter-related infections. Am J Kidney Dis. 1996;27:754–8.

    Article  PubMed  CAS  Google Scholar 

  51. Piraino B. Infectious complications of peritoneal dialysis. Perit Dial Int. 1997;17:S15–8.

    PubMed  Google Scholar 

  52. Szeto CC, Chow KM, Leung CB, Wong TYH, Wu AKL, Wang AYM, Lui SF, Li PKT. Clinical course of peritonitis due to Pseudomonas species complicating peritoneal dialysis: A review of 104 cases. Kidney Int. 2001;59:2309–15.

    PubMed  CAS  Google Scholar 

  53. Gokal R, Alexander SR, Chen TW et al. Peritoneal catheters and exit site practices. Toward optimum peritoneal access: 1998 update. Pediatr Dial Int. 1998;18:11–13.

    CAS  Google Scholar 

  54. Oh J, Von Baum H, Klaus G et al. Nasal carriage of Staphylococcus aureus in families of children on peritoneal dialysis. Adv Perit Dial. 2000;16:324–7.

    PubMed  CAS  Google Scholar 

  55. Oh J, Baum M, Wuhl E et al. Nasal mupirocin prophylaxis reduces the incidence of PD-related S. aureus infections in children: results of a double-blind, placebo-controlled multicenter trial. Perit Dial Int. 2002;22:S74.

    Google Scholar 

  56. Kingwatanakul P, Warady BA. Staphylococcus aureus nasal carriage in children receiving long-term peritoneal dialysis. Adv Perit Dial. 1997;13:280–4.

    Google Scholar 

  57. Bernardini J, Piraino B, Holley J, Johnston JR, Lutes RA. A randomized trial of Staphylococcus aureus prophylaxis in peritoneal dialysis patients: mupirocin calcium ointment 2% applied to the exit site versus cyclic oral rifampin. Am J Kidney Dis. 1996;27:695–700.

    Article  PubMed  CAS  Google Scholar 

  58. Thodis E, Bhaskaran S, Pasadakis P, Bargman JM, Vas SI, Oreopoulos DG. Decrease in Staphylococcus aureus exit-site infections and peritonitis in CAPD patients by local application of Mupirocin ointment at the catheter exit site. Perit Dial Int. 1998;18:261–70.

    PubMed  CAS  Google Scholar 

  59. Annigeri R, Conly J, Vas SI, Dédier H, Prakashan KP, Bargman JM, Jassal V, Oreopoulos DG. Emergence of mupirocin-resistant Staphylococcus aureus in chronic peritoneal dialysis patients using mupirocin prophylaxis to prevent exit-site infection. Perit Dial Int. 2001;21:554–9.

    PubMed  CAS  Google Scholar 

  60. Thomas DG, Wilson JM, Day MJ, Russell AD. Mupirocin resistance in staphylococci: Development and transfer of isoleucyl-tRNA systhetase-mediated resistance in vitro. J Appl Microbiol. 1999;86:715–22.

    Article  PubMed  CAS  Google Scholar 

  61. Miller MA, Dascal A, Portnoy J, Mendelson J. Development of mupirocin resistance among methicillin-resistant Staphylococcus aureus after widespread use of nasal mupirocin ointment. Concise Commun. 1996;17:811.

    CAS  Google Scholar 

  62. Smith CA. Reduced incidence of peritonitis by utilizing “flush before fill” in APD. Adv Perit Dial. 1997;13:224–6.

    PubMed  CAS  Google Scholar 

  63. Edefonti A, Consalvo G, Pappalettera M. Infectious complications in pediatric patients treated with chronic peritoneal dialysis. Perit Dial Int. 1996;16(Suppl 1):S543–7.

    PubMed  Google Scholar 

  64. Holloway M, Mujais S, Kandert M, Warady BA. Pediatric peritoneal dialysis training: characteristics and impact on peritonitis rates. Perit Dial Int. 2001;21:401–4.

    PubMed  CAS  Google Scholar 

  65. Keane WF, Baillie GR, Boeschoten E, Gokal R, Golper T, Holmes CJ, Kawaguchi Y, Piraino B, Riella M, Vas S. Adult peritoneal dialysis-related peritonitis treatment recommendations: 2000 update. Perit Dial Int. 2000;20:396–411.

    PubMed  CAS  Google Scholar 

  66. Hospital Infection Control Practices Advisory Committee (HICPAC). Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidermiol. 1995;16:105–13.

    Article  Google Scholar 

  67. Smith TL, Pearson ML, Wilcox KR et al. Emergence of vancomycin resistance in Staphylococcus aureus. N Engl J Med. 1999;316:927–31.

    Google Scholar 

  68. Teitelbaum I. Vancomycin for the initial therapy of peritonits: don’t throw out the baby with the bathwater [editorial/commentary]. Perit Dial Int. 2001;21:235–8.

    PubMed  CAS  Google Scholar 

  69. Hockensmith ML, Madinger NE, Teitelbaum I. Concerns regarding recommendations for the treatment of CAPD peritonitis [letter to the editor]. Perit Dial Int. 2001;21:318–19.

    Google Scholar 

  70. Warady BA, Reed L, Murphy G et al. Aminoglycoside ototoxicity in pediatric patients receiving long-term peritoneal dialysis. Pediatr Nephrol. 1993;7:178–81.

    Article  PubMed  CAS  Google Scholar 

  71. Shemin D, Maaz D, St.Pierre D et al. Effect of aminoglycoside use on residual renal function in peritoneal dialysis patients. Am J Kidney Dis. 1999;31:14–20.

    Article  Google Scholar 

  72. Singhal MK, Bhaskaran S, Vidgen E et al. Rate of decline of residual renal function in patients on continuous peritoneal dialysis and factors affecting it. Perit Dial Int. 2000;20:429–38.

    PubMed  CAS  Google Scholar 

  73. Rusthoven E, Monnens LAH, Schroder CH. Effective treatment of peritoneal dialysis-associated peritonitis with cefazolin and ceftazidime in children. Perit Dial Int. 2001;21:386–9.

    PubMed  CAS  Google Scholar 

  74. Vychytil A, Lorenz M, Schneider B et al. New criteria for management of catheter infections in peritoneal dialysis patients using ultrasonography. J Am Soc Nephrol. 1998;9:290–6.

    PubMed  CAS  Google Scholar 

  75. Blowey DL, Garg UC, Kearns GL, Warady BA. Peritoneal penetration of amphotericin B lipid complex and fluconazole in a pediatric patient with fungal peritonitis. Adv Perit Dial. 1998;14:247–50.

    PubMed  CAS  Google Scholar 

  76. Dahl NV, Foote EF, Searson KM, Fein JL, Kapoian T, Steward CA, Sherman RA. Pharmacokinetics of intraperitoneal fluconazole during continuous cycling peritoneal dialysis. Ann Pharmacother. 1998;32:1284–9.

    Article  PubMed  CAS  Google Scholar 

  77. Robitaille P, Merouani A, Clermont MJ et al. Successful antifungal prophylaxis in chronic peritoneal dialysis: A pediatric experience. Perit Dial Int. 1995;15:77–9.

    PubMed  CAS  Google Scholar 

  78. de Boer AW, Levi M, Reddingius R, Willems JL, van den Bosch S, Schroder CH et al. Intraperitoneal hypercoagulation and hypofibrinolysis is present in childhood peritonitis. Pediatr Nephrol. 1999;13:284–7.

    Article  PubMed  Google Scholar 

  79. Klaus G, Schaefer F, Querfeld U, Soergel M, Wolf S, Mehls O. Treatment of relapsing peritonitis in pediatric patients on peritoneal dialysis. Adv Perit Dial. 1992;8:302–5.

    PubMed  CAS  Google Scholar 

  80. Williams AJ, Boletis I, Johnson BF et al. Tenckhoff catheter replacement or intraperitoneal urokinase: A randomized trial in the management of recurrent continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Perit Dial Int. 1989;9:65–7.

    PubMed  CAS  Google Scholar 

  81. Innes A, Burden RP, Finch RG et al. Treatment of resistant peritonitis in continuous ambulatory peritoneal dialysis with intraperitoneal urokinase: A double-blind clinical trial. Nephrol Dial Transplant. 1994;9:797–9.

    PubMed  CAS  Google Scholar 

  82. Shea M, Hmiel SP, Beck AM. Use of tissue plasminogen activator for thrombolysis in occluded peritoneal dialysis catheters in children. Adv Perit Dial. 2001;17:249–52.

    PubMed  CAS  Google Scholar 

  83. Buggy BP. Culture methods for continuous ambulatory peritoneal dialysis-associated peritonitis. Clin Microbiol Newslett. 1986;8:12–4.

    Article  Google Scholar 

  84. Swartz RD, Messana JM. Simultaneous catheter removal and replacement in peritoneal dialysis infections: Update and current recommendations. Adv Perit Dial. 1999;15:205–8.

    PubMed  CAS  Google Scholar 

  85. Majkowski NL, Mendley SR. Simultaneous removal and replacement of infected peritoneal dialysis catheters. Am J Kidney Dis. 1997;29:706–11.

    Article  PubMed  CAS  Google Scholar 

  86. Andreoli SP, Langefeld CD, Stadler S et al. Risks of peritoneal membrane failure in children undergoing long-term peritoneal dialysis. Pediatr Nephrol. 1993;7:543–7.

    Article  PubMed  CAS  Google Scholar 

  87. Schroder CH, van Dreumel MJ, Reddingius R et al. Peritoneal transport kinetics of glucose, urea, and creatinine during infancy and childhood. Perit Dial Int. 1991;12:322–5.

    Google Scholar 

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Warady, B.A., Schaefer, F.S. (2004). Peritonitis. In: Warady, B.A., Schaefer, F.S., Fine, R.N., Alexander, S.R. (eds) Pediatric Dialysis. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1031-3_24

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